New treatment could break the dangerous cycle between high blood pressure and kidney damage.
NEW YORK, Oct 5: A new medication called baxdrostat shows early promise in reducing blood pressure and improving kidney health in patients with chronic kidney disease (CKD) who struggle with uncontrolled hypertension. Initial research indicates that adding baxdrostat to standard treatment may help lower blood pressure and slow kidney disease progression in these high-risk individuals. These findings were presented at the American Heart Association’s Hypertension Scientific Sessions 2025 and recently published in the Journal of the American Society of Nephrology.
Chronic kidney disease and high blood pressure are closely linked, and poor management of either can lead to serious complications such as heart attack, stroke, heart failure, and kidney failure. Aldosterone, a hormone produced by the adrenal glands, plays a key role in this connection. It promotes sodium retention, which increases water retention and raises blood pressure. Persistently high aldosterone levels can thicken and stiffen blood vessels, causing damage to the heart and scarring of the kidneys, making it a critical factor in both conditions.
“These findings offer hope for people living with chronic kidney disease and high blood pressure, two conditions that often worsen each other in a harmful cycle,” said lead study author Dr. Jamie P. Dwyer, professor of medicine in nephrology and hypertension at University of Utah Health in Salt Lake City. “High blood pressure can accelerate kidney damage, and declining kidney function can further increase blood pressure, leading to serious health consequences.”
The study aimed to determine whether adding baxdrostat to standard treatment is safe and effective for lowering blood pressure in patients with advanced chronic kidney disease—those expected to develop kidney failure or require a transplant—and uncontrolled hypertension. Participants continued to have high blood pressure despite treatment with either an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB), two common medications targeting hormones involved in blood pressure regulation.
At the start of the trial, participants had an average systolic blood pressure of 151 mm Hg, despite ongoing treatment, with laboratory tests confirming kidney disease. Urine tests showed elevated levels of the protein albumin, averaging 714 mg per gram of creatinine—far above the 30 mg/g threshold, indicating kidney disease. Blood tests measuring estimated glomerular filtration rate (eGFR), a key kidney function indicator, averaged 44 mL/min/1.73 m²; persistent eGFR values below 60 are diagnostic for chronic kidney disease.
Of 195 patients enrolled, 192 were randomized to receive either low-dose baxdrostat (0.5 mg–1 mg), high-dose baxdrostat (2 mg–4 mg), or placebo, alongside standard care. Three participants discontinued early due to adverse effects, personal choice, or other reasons.